Devices and methods for fluid transfer through a placed peripheral intravenous catheter

ABSTRACT

An apparatus includes a catheter, an introducer, and an actuator. A distal end portion of the introducer is configured to be coupled to a peripheral intravenous line. The introducer defines an inner volume having a first portion that defines an axis parallel to and offset from an axis defined by a second portion. A first portion of the actuator is movably disposed in the first portion of the inner volume. A second portion of the actuator is movably disposed in the second portion of the inner volume and coupled to the catheter movably disposed in the second portion of the inner volume. The actuator moves the catheter between a first position, in which the catheter is disposed within the introducer, and a second position, in which at least a portion of the catheter is disposed within the peripheral intravenous line.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. patent application Ser. No.16/419,191 entitled “Devices and Methods for Fluid Transfer Through aPlaced Peripheral Intravenous Catheter”, filed May 22, 2019, which is acontinuation of U.S. patent application Ser. No. 15/014,834 entitled“Devices and Methods for Fluid Transfer Through a Placed PeripheralIntravenous Catheter”, filed Feb. 3, 2016 (now U.S. Pat. No.10,300,247), the disclosures of each of which are incorporated herein byreference in their entirety.

BACKGROUND

The embodiments described herein relate generally to fluid transfermedical devices. More particularly, the embodiments described hereinrelate to devices and methods for transferring fluid to or from apatient through a placed peripheral intravenous catheter.

The typical hospitalized patient encounters a needle every time a doctororders a lab test. The standard procedure for blood extraction involvesusing a metal needle (“butterfly needle”) to “stick” patients' veins intheir arms or hands. Blood drawing is a manual, labor-intensive process,with the average patient requiring hours of direct skilled labor duringa typical hospital stay. This needle stick is not only painful and amajor source of patient dissatisfaction, but the nurses or specializedblood drawing personnel (phlebotomists) often have difficulty findingthe vein in approximately 10-15% of patients, resulting in multiple,painful “stick” attempts. This results in significantly higher materialand labor costs (needles and tubing must be disposed of after everyattempt) and increased patient pain and bruising.

The current process for drawing blood is inefficient, taking on average7-10 minutes, and more than 21 minutes for 10% of patients. These 10% ofpatients are referred to as Difficult Intra-Venous Access or morecommonly as “tough stick” patients. If superficial veins are not readilyapparent, blood can be forced into the vein by massaging the arm fromwrist to elbow, tapping the site with the index and middle finger,applying a warm, damp washcloth to the site for 5 minutes, or bylowering the extremity over the bedside to allow the veins to fill. Eachof these methods is time consuming and therefore costly.

Peripheral IV catheters (PIVs) are inserted into most patients whilethey are hospitalized and used for infusing fluids and medications.However, they are not designed for blood extractions. The failure ratesfor aspiration reach 20-50% when PIVs have been left inserted for morethan a day. Blood extracted from PIVs is often hemolyzed, defined as therupture of red blood cells and the release of their contents intosurrounding fluid, resulting in a discarded sample and need to repeatthe blood collection.

Several barriers can contribute to the shortcomings of extracting bloodthrough a PIV. First, most catheters are formed from a soft bio-reactivepolymer, the use of this material has led to a potential narrowing orcollapse of the catheter as the negative pressure is applied foraspiration. Another barrier is that longer indwelling times can increasedebris (e.g., fibrin/platelet clots) that builds up on the tip of thecatheter and within the lumen of the catheter and/or PIV. Similarly,such debris can at least partially occlude the lumen of the vein withinwhich the PIV is placed. In some instances, this debris (e.g.,fibrin/platelet clots) around the PIV can lead to reduced blood flowwithin portions of the vein surrounding the inserted PIV (e.g., bothupstream and downstream), which in turn, results in improper and/orinefficient aspiration. Another barrier is attributed to a “suction cup”effect, wherein the negative pressure created by aspiration through thecatheter and the possible curved path of a vein result in the tip of thecatheter adhering to the wall of the vein. As the negative pressureincreases the vein can rupture resulting in “blowing the vein”, which isa concern for phlebotomists during aspiration through a PIV.

Thus, a need exists for an improved system and method for phlebotomythrough a peripheral intravenous catheter.

SUMMARY

Devices and methods for transferring fluid to or from a patient througha placed peripheral intravenous catheter are described herein. In someembodiments, an apparatus includes a catheter, an introducer, and anactuator. The catheter has a proximal end portion and a distal endportion and defines a lumen extending through the proximal end portionand the distal end portion. The introducer has a proximal end portionand a distal end portion configured to be coupled to a peripheralintravenous line. The introducer defines an inner volume having atortuous cross-sectional shape such that an axis defined by a firstportion of the inner volume is parallel to, and offset from, an axisdefined by a second portion of the inner volume. The second portion ofthe inner volume movably receives the catheter. The actuator includes afirst portion that is movably disposed in the first portion of the innervolume and a second portion that is movably disposed in the secondportion of the inner volume. The second portion of the actuator iscoupled to the catheter. The actuator is configured to move relative tothe introducer to move the catheter between a first position, in whichthe catheter is disposed within the introducer, and a second position,in which the distal end portion of the catheter is disposed beyond thedistal end portion of the introducer such that at least a portion of thecatheter is disposed within the peripheral intravenous line when theintroducer is coupled thereto.

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1 and 2 are schematic illustrations of a fluid transfer device ina first configuration and a second configuration, respectively,according to an embodiment.

FIG. 3 is a perspective view of a fluid transfer device in a firstconfiguration, according to an embodiment.

FIG. 4 is a top view of the fluid transfer device illustrated in FIG. 3.

FIG. 5 is an exploded view of the fluid transfer device illustrated inFIG. 3 .

FIG. 6 is a perspective view of a first member of an introducer includedin the fluid transfer device of FIG. 3 .

FIG. 7 is a perspective view of a second member of the introducerincluded in the fluid transfer device of FIG. 3 .

FIG. 8 is a side view of the second member illustrated in FIG. 7 .

FIG. 9 is an enlarged view of a portion of the second member identifiedin FIG. 8 by the region A1.

FIG. 10 is a rear perspective view of the introducer formed by couplingthe first member illustrated in FIG. 6 to the second member illustratedin FIG. 7 .

FIG. 11 is a front perspective view of the introducer illustrated inFIG. 10 .

FIG. 12 is a cross-sectional view of the introducer taken along the line12-12 in FIG. 11 .

FIGS. 13 and 14 are a rear perspective view and a top view,respectively, of a lock included in the fluid transfer device of FIG. 3.

FIG. 15 is a cross-sectional view of the lock taken along the line 15-15in FIG. 14 .

FIG. 16 is an exploded perspective view a catheter, a secondarycatheter, and an actuator included in the fluid transfer device of FIG.3 .

FIGS. 17-19 are a perspective view, a side view, and a front view,respectively, of the actuator illustrated in FIG. 16 .

FIG. 20 is a cross-sectional view of the fluid transfer device takenalong the line 20-20 in FIG. 4 .

FIG. 21 is a side view of the fluid transfer device of FIG. 3 in thefirst configuration.

FIG. 22 is a cross-sectional view of the fluid transfer device in thefirst configuration taken along the line 22-22 in FIG. 3 .

FIG. 23 is an enlarged cross-sectional view of a portion of the fluidtransfer device identified by the region A2 in FIG. 22 .

FIG. 24 is an enlarged cross-sectional view of a portion of the fluidtransfer device identified by the region A3 in FIG. 22 .

FIG. 25 is a side view of the fluid transfer device of FIG. 3 as thefluid transfer device is being transitioned from the first configurationto a second configuration.

FIG. 26 is an enlarged view of a portion of the fluid transfer deviceidentified by the region A4 in FIG. 24 .

FIG. 27 is a side view of the fluid transfer device of FIG. 3 in thesecond configuration.

FIG. 28 is a cross-sectional view of the fluid transfer device in thesecond configuration taken along the line 22-22 in FIG. 3 .

FIG. 29 is an enlarged cross-sectional view of a portion of the fluidtransfer device identified by the region A5 in FIG. 28 .

FIG. 30 is a flowchart illustrating a method of using a fluid transferdevice according to an embodiment.

DETAILED DESCRIPTION

Devices and methods for transferring fluid to or from a patient througha placed peripheral intravenous catheter are described herein. In someembodiments, an apparatus includes a catheter, an introducer, and anactuator. The catheter has a proximal end portion and a distal endportion and defines a lumen extending through the proximal end portionand the distal end portion. The introducer has a proximal end portionand a distal end portion configured to be coupled to a peripheralintravenous line. The introducer defines an inner volume having atortuous cross-sectional shape such that an axis defined by a firstportion of the inner volume is parallel to, and offset from, an axisdefined by a second portion of the inner volume. The second portion ofthe inner volume movably receives the catheter. The actuator includes afirst portion that is movably disposed in the first portion of the innervolume and a second portion that is movably disposed in the secondportion of the inner volume. The second portion of the actuator iscoupled to the catheter. The actuator is configured to move relative tothe introducer to move the catheter between a first position, in whichthe catheter is disposed within the introducer, and a second position,in which the distal end portion of the catheter is disposed beyond thedistal end portion of the introducer such that at least a portion of thecatheter is disposed within the peripheral intravenous line when theintroducer is coupled thereto.

In some embodiments, an apparatus includes a catheter, an introducer, anactuator, and a lock. The catheter has a proximal end portion and adistal end portion and defines a lumen extending through the proximalend portion and the distal end portion. The introducer has a proximalend portion and a distal end portion and defines an inner volume thatmovably receives the catheter. The actuator has a first portion disposedoutside of the inner volume and a second portion disposed within theinner volume. The second portion of the actuator is coupled to thecatheter. The actuator is configured to move relative to the introducerto move the catheter between a first position and a second position. Thelock is coupled to the distal end portion of the introducer. The lockhas a proboscis and defines a lumen extending through the proboscis. Thelock is configured to be coupled to a peripheral intravenous line suchthat the proboscis extends through a lumen defined by the peripheralintravenous line when the lock is coupled thereto. The lumen of theproboscis receives a portion of the catheter as the catheter is movedfrom the first position, in which the catheter is disposed within theinner volume of the introducer, to the second position, in which thedistal end portion of the catheter extends beyond the peripheralintravenous line when the lock is coupled thereto. An inner surface ofthe proboscis is configured to guide the catheter as the catheter ismoved from the first position to the second position.

In some embodiments, an apparatus includes a catheter, an introducer,and an actuator. The catheter has a proximal end portion and a distalend portion and defines a lumen extending through the proximal endportion and the distal end portion. The introducer has a first memberand a second member coupled to the first member. The second member hasan outer surface forming a plurality of ribs. The first member and thesecond member collectively define an inner volume and a slot incommunication with the inner volume. The inner volume receives thecatheter. A distal end portion of the introducer configured to becoupled to a peripheral intravenous line. The actuator is operativelycoupled to the introducer such that a first portion of the actuator isdisposed outside of the inner volume and a second portion of theactuator extends through the slot and disposed in the inner volume. Thefirst portion of the actuator includes a surface that is in contact withthe outer surface of the second member. The second portion of theactuator is coupled to the catheter. The actuator is configured to moverelative to the introducer to move the catheter between a firstposition, in which the catheter is disposed within the introducer, and asecond position, in which the distal end portion of the catheter isdisposed beyond the peripheral intravenous line when the introducer iscoupled to the peripheral intravenous line. The surface of the firstportion of the actuator moves along the plurality of ribs as theactuator moves the catheter between the first position and the secondposition to provide, to a user, a haptic feedback associated with aposition of the distal end portion of the catheter.

In some embodiments, a method includes coupling a lock of a fluidtransfer device to an indwelling peripheral intravenous line. The fluidtransfer device includes an introducer having a distal end portioncoupled to the lock, a catheter movably disposed in an inner volumedefined by the introducer, and an actuator. The actuator extends througha slot defined by the introducer such that a first portion of theactuator is disposed outside of the inner volume and in contact with anouter surface of the introducer and a second portion of the actuator isdisposed within the inner volume of the introducer and coupled to thecatheter. The actuator is moved relative to the introducer to advancethe catheter from a first position, in which the catheter is disposedwithin at least one of the inner volume or the lock, toward a secondposition. An indication associated with a position of a distal endportion of the catheter as the actuator moves the catheter from thefirst position toward the second position is provided to a user. Theindication is in the form of a haptic output produced by a surface ofthe actuator being moved along a plurality of ribs included on the outersurface of the introducer. The catheter is placed in the second positionbased on the indication associated with the distal end portion of thecatheter. The distal end portion of the catheter is disposed beyond atleast a portion of the peripheral intravenous line when the catheter isin the second position.

As used herein, the terms “catheter” and “cannula” are usedinterchangeably to describe an element configured to define a passagewayfor moving a bodily fluid from a first location to a second location(e.g., a fluid passageway to move a bodily fluid out of the body). Whilecannulas can be configured to receive a trocar, a guide wire, or anintroducer to deliver the cannula to a volume inside the body of apatient, the cannulas referred to herein need not include or receive atrocar, guide wire, or introducer.

As used in this specification, the terms “Y-adapter” and “T-adapter” areused to refer to a dual port IV extension set. In this manner, the terms“Y-adapter” and “T-adapter” generally describe an overall shape of thedual port IV extension set. For example, as used herein, a Y-adapter issubstantially “Y” shaped including a single port at a first end and twoports angularly disposed at a second end. Furthermore, the terms“Y-adapter” and “T-adapter” are included by way of example only and notlimitation. For example, in some embodiments, an apparatus can include asingle port IV extension set (e.g., a single port adapter) or amulti-port IV extension set (e.g., an adapter with more than two ports).

As used in this specification, the words “proximal” and “distal” referto the direction closer to and away from, respectively, a user who wouldplace the device into contact with a patient. Thus, for example, the endof a device first touching the body of the patient would be the distalend, while the opposite end of the device (e.g., the end of the devicebeing manipulated by the user) would be the proximal end of the device.

As used herein, the term “stiffness” relates to an object's resistanceto deflection, deformation, and/or displacement by an applied force.Stiffness can be characterized in terms of the amount of force appliedto the object and the resulting distance through which a first portionof the object deflects, deforms, and/or displaces with respect to asecond portion of the object. When characterizing the stiffness of anobject, the deflected distance may be measured as the deflection of aportion of the object different from the portion of the object to whichthe force is directly applied. Said another way, in some objects, thepoint of deflection is distinct from the point where force is applied.

Stiffness is an extensive property of the object being described, andthus is dependent upon the material from which the object is formed aswell as certain physical characteristics of the object (e.g., shape andboundary conditions). For example, the stiffness of an object can beincreased or decreased by selectively including in the object a materialhaving a desired modulus of elasticity, flexural modulus, and/orhardness. The modulus of elasticity is an intensive property of (i.e.,is intrinsic to) the constituent material and describes an object'stendency to elastically (i.e., non-permanently) deform in response to anapplied force. A material having a high modulus of elasticity will notdeflect as much as a material having a low modulus of elasticity in thepresence of an equally applied stress. Thus, the stiffness of the objectcan be increased, for example, by introducing into the object and/orconstructing the object of a material having a high modulus ofelasticity.

Similarly, a material's hardness is an intensive property of theconstituent material and describes the measure of how resistant thematerial is to various kinds of permanent shape change when a force isapplied. In discussing the hardness and the subsequent effect on thestiffness of a catheter, the Shore durometer scale is generally used.There are several scales for durometers with two commonly used indescribing plastics, polymers, elastomers, and/or rubbers, namely, typeA and type D, where type A is generally used for softer materials andtype D is generally used for harder materials. The Shore durometer of amaterial is denoted by a number between 0 and 100, with higher numbersindicating a harder material, followed by the type of scale. Forinstance, a first material can be measured as having a Shore durometerof 40 Shore A and a second material can be measured as having a Shoredurometer of 20 Shore D. Therefore, according to the Shore durometerscale, the second material is harder and thus, more stiff than the firstmaterial.

FIGS. 1 and 2 are schematic illustrations of a fluid transfer device 100for phlebotomy through a peripheral intravenous line or catheter in afirst configuration and second configuration, respectively, according toan embodiment. The fluid transfer device 100 (also referred to herein as“transfer device”) can be any suitable shape, size, and/orconfiguration. As described in further detail herein, the transferdevice 100 is configured to couple to and/or otherwise engage anindwelling peripheral intravenous catheter (PIV) 105 to transfer fluidfrom (e.g., aspiration of blood) and/or transfer fluid to (e.g.,infusion of a drug or substance) a portion of a patient.

The transfer device 100 includes at least an introducer 110, a catheter160 (or cannula), and an actuator 170. The introducer 110 can be anysuitable configuration. For example, in some embodiments, the introducer110 can be an elongate member having a substantially circularcross-sectional shape. In some embodiments, the shape of the introducer110 and/or one or more features or surface finishes of at least an outersurface of the introducer 110 can be arranged to increase the ergonomicsof the transfer device 100, which in some instances, can allow a user tomanipulate the transfer device 100 with one hand (i.e., single-handeduse).

The introducer 110 has a proximal end portion proximal end portion 111and a distal end portion 112 and defines an inner volume 113. Althoughnot shown in FIGS. 1 and 2 , the proximal end portion 111 of theintroducer 110 can include an opening or port configured to movablyreceive a portion of the catheter 160. As such, a first portion of thecatheter 160 can be disposed within the inner volume 113 and a secondportion of the catheter 160 can be disposed outside of the inner volume113. The opening or port can be any suitable configuration. For example,in some embodiments, the opening and/or port can include a seal or thelike configured to form a substantially fluid tight seal with an outersurface of the portion of the catheter 160 disposed therein. In otherembodiments, the arrangement of the opening and/or port can be such thata user can place the catheter 160 in selective contact with a surface ofthe proximal end portion 111 defining the opening and/or port, which inturn, can clamp and/or pinch the catheter 160 to selectively obstruct alumen of the catheter 160, as described in further detail herein withreference to specific embodiments.

The distal end portion 112 of the introducer 110 includes and/or iscoupled to a lock configured to physically and fluidically couple theintroducer 110 to the PIV 105 (see e.g., FIG. 2 ). For example, in someembodiments, the distal end portion 112 can include a coupler or thelike such as a Luer Lok™ or the like configured to physically andfluidically couple to an associated coupler of the lock. In someembodiments, the lock is configured to selectively engage and/or contactthe PIV 105 to couple the introducer 110 thereto. For example, in someembodiments, the shape, size, and/or arrangement of the lock is suchthat the lock forms three points of contact with the PIV 105. In someembodiments, such an arrangement can provide structural rigidity and/orsupport to the PIV 105 as a portion of the lock (e.g., a proboscis orthe like) is inserted into a portion of the PIV 105, as described infurther detail herein.

In some embodiments, the distal end portion 112 of the introducer 110(and/or the lock) can include a seal or the like that can be transferredfrom a sealed configuration to a substantially open configuration toplace at least a portion of the inner volume 113 in fluid communicationwith the lock. In some embodiments, the seal can include back flowprevention mechanism such as a one-way valve or the like that can allow,for example, the catheter 160 to be advanced in the distal directiontherethrough while limiting and/or substantially preventing a fluidflow, outside the catheter 160, in the proximal direction through theseal.

As described above, the introducer 110 defines the inner volume 113,which extends between the proximal end portion 111 and the distal endportion 112. The inner volume 113 has and/or defines a first portion 114configured to receive a first portion 171 of the actuator 170 and asecond portion 115 configured to receive the catheter 160 and a secondportion 175 of the actuator 172, as shown in FIGS. 1 and 2 . Morespecifically, an inner surface of the introducer 110 that defines theinner volume 113 can have, for example, a tortuous cross-sectional shape(not shown in FIGS. 1 and 2 ) such that an axis defined by the firstportion 114 of the inner volume 113 is parallel to and offset from anaxis defined by the second portion 115 of the inner volume 113. In thismanner, the first portion 114 of the inner volume 113 can be spacedapart from the second portion 115 of the inner volume 113 without beingfluidically isolated therefrom. In some embodiments, the first portion114 of the inner volume 113 can extend through a wall of the introducer110. In other words, the introducer 110 can define a slot, channel,track, opening, and/or the like that is in fluid communication with thefirst portion 114 of the inner volume 113. Conversely, the secondportion 115 of the inner volume 113 can be entirely defined and/orenclosed (at least in the circumferential direction) by the introducer110. Moreover, in some embodiments, the tortuous cross-sectional shapeof the inner volume 113 is such that the second portion 115 cannot beviewed (e.g., is out of the line of sight) via the slot or the like influid communication with the first portion 114 of the inner volume 113,which in turn, can limit and/or substantially prevent contamination ofthe catheter 160 disposed therein.

The catheter 160 of the transfer device 100 includes a proximal endportion 161 and a distal end portion 162 and defines a lumen 163 thatextends through the proximal end portion 161 and the distal end portion162. The catheter 160 is movably disposed within the second portion 115of the inner volume 113 defined by the introducer 110 and is coupled tothe actuator 170. In some embodiments, the catheter 160 can be moved(e.g., via movement of the actuator 170) between a first position and asecond position to transition the transfer device 100 between the firstconfiguration and the second configuration, respectively. Morespecifically, at least the distal end portion 162 of the catheter 160 isdisposed within the second portion 115 of the inner volume 113 when thecatheter 160 is in the first position (FIG. 1 ) and at least a portionof the catheter 160 extends through the PIV 105 to place a distal end ofthe catheter 160 in a distal position relative to a portion of the PIV105 when the catheter 160 is in the second position (FIG. 2 ). Althoughnot shown in FIGS. 1 and 2 , in some embodiments, the transfer device100 can include a secondary catheter or the like that is coupled to theactuator 170 and in fluid communication with the catheter 160. In suchembodiments, the secondary catheter can be, for example, disposed in aproximal position relative to the catheter 160 and can be configured toextend through the opening and/or port defined by the proximal endportion 111 of the introducer 110. In this manner, a proximal endportion of the secondary catheter can be coupled to a fluid reservoir,fluid source, syringe, and/or the like, which in turn, places thecatheter 160 in fluid communication therewith. Moreover, in embodimentsincluding the secondary catheter, the catheter 160 can be entirelydisposed within the introducer 110 when the catheter 160 is in the firstposition.

The catheter 160 can be any suitable shape, size, and/or configuration.For example, in some embodiments, at least a portion of the catheter 160can have an outer diameter (e.g., between a 16-gauge and a 26-gauge)that is substantially similar to or slightly smaller than an innerdiameter defined by a portion of the lock coupled to the distal endportion 112 of the introducer 110. In this manner, an inner surface ofthe portion of the lock can guide the catheter 160 as the catheter 160is moved between the first position and the second position. In someembodiments, such an arrangement can limit and/or can substantiallyprevent bending, deforming, and/or kinking of the catheter 160 as thecatheter 160 is moved between the first position and the secondposition. In some embodiments, the catheter 160 can have a length thatis sufficient to place a distal surface of the catheter 160 in a desiredposition relative to a distal surface of the PIV 105 when the catheter160 is in the second position. In other words, the length of thecatheter 160 can be sufficient to define a predetermined and/or desireddistance between the distal surface of the catheter 160 and the distalsurface of the PIV 105 when the catheter 160 is in the second position.In some instances, placing the distal surface of the catheter 160 thepredetermined and/or desired distance from the distal surface of the PIV105 can, for example, place the distal surface of the catheter 160 in adesired position within a vein, as described in further detail herein.

The catheter 160 can be formed from any suitable material or combinationof materials, which in turn, can result in the catheter 160 having anysuitable stiffness or durometer. In some embodiments, at least a portionof the catheter 160 can be formed of a braided material or the like,which can change, modify, and/or alter a flexibility of the catheter 160in response to a bending force or the like. In some embodiments, formingthe catheter 160 of the braided material or the like can reduce alikelihood of kinking and/or otherwise deforming in an undesired manner.In addition, forming at least a portion of the catheter 160 of a braidedmaterial can result in a compression and/or deformation in response to acompression force exerted in a direction of a longitudinal centerlinedefined by the catheter 160 (e.g., an axial force or the like). In thismanner, the catheter 160 can absorb a portion of force associated with,for example, impacting an obstruction or the like.

The actuator 170 of the transfer device 100 can be any suitable shape,size, and/or configuration. As described above, the actuator 170includes the first portion 171 movably disposed within the first portion114 of the inner volume 113 and the second portion 175 movably disposedwithin the second portion 115 of the inner volume 113 and coupled to thecatheter 160. Although not shown in FIGS. 1 and 2 , the actuator 170 canhave a cross-sectional shape that is associated with and/or otherwisecorresponds to the cross-sectional shape of the inner volume 113 (e.g.,the tortuous cross-sectional shape). Thus, an axis defined by the firstportion 171 of the actuator 170 is parallel to and offset from an axisdefined by the second portion 175 of the actuator 170.

The arrangement of the actuator 170 and the introducer 110 is such thatthe first portion 171 extends through the slot or the like in fluidcommunication with the first portion 114 of the inner volume 113. Assuch, a first region of the first portion 171 of the actuator 170 isdisposed outside of the introducer 110 and a second region of the firstportion 171 of the actuator 170 is disposed in the first portion 114 ofthe inner volume 113. In this manner, a user can engage the first regionof the first portion 171 of the actuator 170 and can move the actuator170 relative to the introducer 110 to move the catheter 160 coupled tothe second portion 175 of the actuator 170 between the first positionand the second position. Although not shown in FIGS. 1 and 2 , in someembodiments, the first portion 171 of the actuator 170 can include atab, protrusion, and/or surface that is in contact with an outer surfaceof the introducer 110. In such embodiments, the outer surface of theintroducer 110 can include, for example, a set of ribs, ridges, bumps,grooves, and/or the like along which the tab, protrusion, and/or surfaceof the first portion 171 advances when the actuator 170 is movedrelative to the introducer 110, which in turn, produces a haptic outputor feedback which can provide an indication associated with a positionof the distal end portion 162 of the catheter 160 to the user.

In some embodiments, the transfer device 100 can be disposed in thefirst configuration prior to use (e.g., shipped, stored, prepared, etc.in the first configuration). In use, a user can manipulate the transferdevice 100 to couple the introducer 110 to the indwelling PIV 105 (e.g.,via the lock coupled to and/or assembled with the introducer 110). Withthe transfer device 100 coupled to the PIV 105, the user can engage thefirst portion 171 of the actuator 170 to move the actuator 170 relativeto the introducer 110, which in turn, moves the catheter 160 from thefirst position (e.g., disposed within the introducer 110) toward thesecond position. In some embodiments, the arrangement of the actuator170 and the introducer 110 is such that advancing the actuator 170relative to the introducer 110 produces a haptic output and/or feedbackconfigured to provide and indicator associated with position of thedistal end portion 162 of the catheter 160 relative to the introducer110 and/or the PIV 105 to the user. For example, based on the hapticfeedback or the any other suitable indicator, the user can place thecatheter 160 in the second position such that the distal surface of thecatheter 160 extends a desired distance beyond the distal surface of thePIV 105, as described above.

With the catheter 160 in the second position (e.g., with the transferdevice 100 in the second configuration shown in FIG. 2 ), the user canestablish fluid communication between a fluid reservoir, fluid source,syringe, and/or the like and the catheter 160. For example, as describedabove, in some embodiments, the user can couple the secondary catheter(not shown) to the fluid reservoir, fluid source, syringe, and/or thelike. Although described as establishing fluid communication between thecatheter 160 and the fluid reservoir or fluid source after placing thecatheter 160 in the second position, in other embodiments, the user canestablish fluid communication between the catheter 160 and the fluidreservoir or fluid source prior to moving the actuator 170 relative tothe introducer 110. With the catheter 160 in fluid communication withthe fluid reservoir and/or fluid source, the transfer device 100 canthen transfer a fluid from the patient or transfer a fluid to thepatient via the catheter 160 extending through and beyond the PIV 105.

FIGS. 3-29 illustrate a fluid transfer device 200 according to anotherembodiment. The fluid transfer device 200 (also referred to herein as“transfer device”) can be any suitable shape, size, or configuration andcan be coupled to a PIV (not shown in FIGS. 3-29 ), for example, via alock and/or adapter. As described in further detail herein, a user cantransition the transfer device 200 from a first configuration to asecond configuration to advance a catheter through an existing, placed,and/or indwelling PIV (i.e., when the transfer device 200 is coupledthereto) such that at least an end portion of the catheter is disposedin a distal position relative to the PIV. Moreover, with peripheralintravenous lines each having a shape, size, and/or configuration thatcan vary based on, for example, a manufacturer of the PIV and/or itsintended usage, the transfer device 200 can be arranged to allow thetransfer device 200 to be coupled to a PIV having any suitableconfiguration and subsequently, to advance at least a portion of acatheter through the PIV substantially without kinking, snagging,breaking, and/or otherwise reconfiguring the catheter in an undesirablemanner. In addition, the transfer device 200 can be manipulated by auser to place a distal surface of the catheter a predetermined and/ordesired distance beyond a distal surface of the PIV to be disposedwithin a portion of a vein that receives a substantially unobstructedflow of blood.

As shown in FIGS. 3-5 , the transfer device 200 includes an introducer210, a lock 240, a catheter 260, a secondary catheter 265, and anactuator 270. The introducer 210 can be any suitable shape, size, orconfiguration. For example, in some embodiments, the introducer 210 canbe an elongate member having a substantially circular cross-sectionalshape. In some embodiments, the shape of the introducer 210 and/or oneor more features or surface finishes of at least an outer surface of theintroducer 210 can be arranged to increase the ergonomics of thetransfer device 200, which in some instances, can allow a user tomanipulate the transfer device 200 with one hand (i.e., single-handeduse).

As shown in FIGS. 5-12 , the introducer 210 of the transfer device 200includes a first member 220 and a second member 225 that are coupled tocollectively form the introducer 210. As shown in FIG. 6 , the firstmember 220 includes a proximal end portion 221, a distal end portion222, and an inner surface 224. The inner surface 224 has a first portion224 and a second portion 225. The proximal end portion 221 of the firstmember 220, and more specifically, a proximal wall of the first member220 defines a notch 226 configured to selectively receive a portion ofthe secondary catheter 265, as described in further detail herein.

As shown in FIGS. 7-9 , the second member 230 has a proximal end portion231, a distal end portion 232, an inner surface 233, and an outersurface 235. As described above with reference to the first member 220,the proximal end portion 231 of the second member 230, and morespecifically, a proximal wall of the second member 230 defines a notch234 configured to selectively receive a portion of the secondarycatheter 265. The outer surface 235 of the second member 230 includes aset of ribs 236 distributed along a length of the second member 230.More particularly, each rib 236 extends along a width of the secondmember 230 and successively distributed along the length of the secondmember 230. In this manner, the outer surface 235 defines alternatinglocal minima and local maxima arranged along the length of the secondmember 230. As described in further detail herein, a portion of theactuator 270 is configured to be advanced along the outer surface 235forming the set of ribs 236 as a user moves the actuator 270 relative tothe introducer 210, which in turn, vibrates the actuator 270 (and thecatheter 260 coupled thereto). In some instances, this vibration can,for example, facilitate the advancing of the catheter 260 through aportion or the transfer device 200, a portion of the PIV, and/or aportion of the vasculature. Moreover, in some instances, the vibrationcan provide a user with a haptic and/or audible indicator associatedwith a position of the catheter 260 relative to the introducer 210and/or PIV, as described in further detail herein.

The ribs 236 formed by the outer surface 235 of the second member 230can be any suitable shape, size, and/or configuration. For example, asshown in FIGS. 8 and 9 , the set of ribs 236 includes a first portion237 having a first size and shape, and a second portion 238 having asecond size and shape, different from the first size and shape. Thefirst portion 237 of ribs 236 can have any suitable configuration and/orarrangement. For example, in this embodiment, each rib in the firstportion 237 is substantially uniform having substantially the same sizeand shape. In other embodiments, each rib included in the first portion237 can have a size and shape that is different from the remaining ribsof the first portion 237. For example, in some embodiments, the size andshape of each rib in the first portion 237 can increase from a proximalmost rib having the smallest size and shape to a distal most rib havingthe largest size and shape. Moreover, while the ribs of the firstportion 237 are shown as being substantially symmetrical, in otherembodiments, each rib of the first portion 237 can be asymmetrical. Forexample, in some embodiments, a proximal surface of each rib can have afirst pitch (e.g., angle) and a distal surface of each rib can have asecond pitch that is greater than the first pitch. In some embodiments,such an asymmetric arrangement can be such that the portion of theactuator 270 moves along the outer surface 235 with a first set ofcharacteristics when moved in a distal direction and moves along theouter surface 235 with a second set of characteristics, different fromthe first set of characteristics, when moved in a proximal direction.For example, in some embodiments, the portion of the actuator 270 canmove along the outer surface 235 in the distal direction more freelythan in the proximal direction.

Similarly, the second portion 238 of the ribs 236 can have any suitableconfiguration and/or arrangement. For example, in this embodiment, eachrib in the second portion 238 is substantially uniform havingsubstantially the same size and shape as the remaining ribs in thesecond portion 238. As shown in FIG. 9 , each rib in the second portion238 has a size and shape that is greater than the size and shape of eachrib of the first portion 237. In some instances, the greater size of theribs of the second portion 238 can result in a larger amount ofvibration as the actuator 270 is moved along the outer surface 235 (asdescribed above). In some instances, the greater size of the ribs of thesecond portion 238 can result in an increase in a force otherwisesufficient to move the portion of the actuator 270 along the outersurface 235. While the ribs of the second portion 238 are shown anddescribed as being substantially uniform and having a larger size thanthe ribs of the first portion 237, in other embodiments, the ribs of thesecond portion 238 can have any of the arrangements and/orconfigurations described above with reference to the ribs of the firstportion 237.

While the set of ribs 236 transitions from the first portion 237 to thesecond portion 238 at a given point along the length of the secondmember 230 (see e.g., FIG. 9 ), in other embodiments, the size and shapeof each rib in the set of ribs 236 can increase from a proximal most ribof the first portion 237 having the smallest size and shape to a distalmost rib of the second portion 238 having the largest size and shape. Inother words, in some embodiments, the size and shape of each of rib inthe set of ribs 236 can increase with each successive rib (e.g., in thedistal direction). In still other embodiments, the set of ribs 236 caninclude more than the first portion 237 and the second portion 238. Forexample, in some embodiments, a second member can include a set of ribshaving a first portion and a second portion having a size, shape, andconfiguration similar to the first portion 237 of the second member 230,and a third portion, disposed between the first portion and the secondportion, having a size, shape, and configuration similar to the secondportion 238 of the second member 230. That is to say, in suchembodiments, the second member includes a proximal portion of ribs and adistal end portion of ribs that are smaller than a medial portion ofribs disposed therebetween. In some embodiments, the arrangement of theset of ribs 236 of the second member 230 can be such that a proximalmost rib and a distal most rib are larger and/or otherwise have a shapethat operable to at least temporarily maintain the portion of theactuator 270 in a proximal position relative to the proximal most riband a distal position relative to the distal most rib, respectively.

While the set of ribs 236 are shown as being formed only by the outersurface 235 of the second member 230, in other embodiments, the firstmember 220 can include an outer surface that forms a set of ribs. Insuch embodiments, the set of ribs of the first member 220 can be and/orcan have any of the configurations and/or arrangements described abovewith reference to the set of ribs 236 of the second member 230. In someembodiments, the ribs of the first member 220 can be offset from theribs 236 of the second member 230. For example, in some embodiments, theribs of the first member 220 can have alternating local minima and localmaxima (as described above with reference to the ribs 236) that aredistributed along a length of the first member 220 such that the localminima and local maxima of the ribs of the first member 220 are alignedwith the local maxima and local minima, respectively, of the ribs 236 ofthe second member 230 (e.g., offset along a length of the introducer210). In other embodiments, the ribs of the first member 220 can be invarying positions relative to the ribs 236 of the second member 230. Inthis manner, the introducer 210 can provide a variable arrangement ofribs that can provide, for example, haptic feedback as the actuator 270is moved relative to the introducer 210.

As shown in FIGS. 10-12 , the first member 220 is configured to becoupled to the second member 230 to collectively form the introducer210. For example, in some embodiments, the first member 220 and thesecond member 230 can be coupled via ultrasonic welding, an adhesive, amechanical fastener, one or more tabs, snaps, pins, and/or the like toform the introducer 210. In some embodiments, coupling the first member220 to the second member 230 (e.g., during a manufacturing process) toform the introducer 210 can facilitate and/or simplify one or moremanufacturing processes. For example, in some embodiments, forming theintroducer 210 from the first member 220 and the second member 230 canreduce undesirable variations in the shape and/or size of the innersurface 223 and 233 (e.g., due to draft angles and/or manufacturingtolerances) during manufacturing, which in some instances, can reduce alikelihood of kinks, bends, and/or deformations of the catheter 260during use of the transfer device 200. In some embodiments, forming theintroducer 210 from the first member 220 and the second member 230 canallow at least the inner surface 223 of the first member 220 to form atortuous shape that would otherwise present challenges whenmanufacturing the introducer 210 from a single workpiece.

In other embodiments, a first member 220 can be monolithically formed(e.g., via injection molding and/or any other suitable manufacturingprocess). That is to say, the first member 220 can be formed from asingle workpiece or the like rather than two workpieces, namely, thefirst member 220 and the second member 230. Thus, when referring tofeatures of the first member 220, such features can be formed and/ordefined by the first member 220, formed and/or defined by the secondmember 230, collectively formed and/or defined by the first member 220and the second member 230, or, when the introducer 210 is formed from asingle workpiece, formed and/or defined by a corresponding portion ofthe introducer 210.

The first member 220 and the second member 230 collectively form aproximal end portion 211 and a distal end portion 212 of the introducer210 and collectively define an inner volume 213 of the introducer 210.As shown in FIG. 10 , the proximal end portion 211 of the introducer 210defines an opening 217. Specifically, the opening 217 is collectivelyformed and/or defined by the notch 226 of the first member 220 and thenotch 234 of the second member 230. The arrangement of the proximal endportion 211 is such that a portion of the opening 217 defined by thenotch 226 of the first member 220 has a first size and/or shape and aportion of the opening 217 defined by the notch 234 of the second member230 has a second size and/or shape that is less than the first sizeand/or shape. In other words, a portion of the opening 217 isconstricted, pinched, obstructed, and/or otherwise reduced. As describedin further detail herein, the opening 217 is configured to receive aportion of the secondary catheter 265, which can be moved within theopening 217 from the larger portion of the opening 217 to the reducedportion of the opening 217 (e.g., the portion formed by the notch 234 ofthe second member 230) to obstruct, pinch, and/or clamp the secondarycatheter 265.

As shown in FIG. 11 , the distal end portion 212 of the introducer 210includes and/or otherwise forms a coupler 216. In other words, thedistal end portion 222 of the first member 220 and the distal endportion 232 of the second member 230 collectively form the coupler 216at the distal end portion 212 of the introducer 210. The coupler 216 canbe any suitable shape, size, and/or configuration. For example, in thisembodiments, the coupler 216 forms a set of threads, which can form athreaded coupling with an associated threaded portion of the lock 240,as described in further detail herein. Although not shown in FIG. 11 ,the distal end portion 211 of the introducer 210 can include and/or canbe configured to receive a seal that can selectively seal and/orfluidically isolate the inner volume 213 of the introducer 210 (at leastfrom an open portion of the coupler 216). In use, the seal can betransitioned from a sealed or closed configuration to an openconfiguration to allow, for example, a portion of the catheter 260 topass therethrough. In some embodiments, the seal can contact an outersurface of the catheter 260 to define a seal therebetween that isoperable to limit and/or substantially prevent a back flow of fluidbetween the outer surface of the cannula and the seal.

The seal can be any suitable type of seal. For example, in someembodiments, the seal can be an O-ring, a one-way valve, a diaphragm, aself-healing diaphragm, a check valve, a single crack valve, and/or anyother suitable seal or valve member. In some embodiments, the seal isconfigured to define and/or otherwise have a predetermined “cracking”pressure. That is to say, in some embodiments, the seal can beconfigured to transition from a closed and/or sealed configuration to asubstantially open configuration in response to an increase in pressure,for example, within the introducer 210. In some embodiments, the sealcan be a positive pressure seal or the like. In other embodiments, theseal can be a fluid seal such as a saline lock or the like. Although notshown in FIGS. 5-12 , in some embodiments, the introducer 210 caninclude a device, mechanism, assembly, and/or the like, which can bemanipulated to increase a pressure (e.g., via air or other suitablefluid or liquid) within the introducer 210 to transition the seal fromthe closed configuration to the open configuration. For example, theintroducer 210 can include and/or can be coupled to a bulb, pump, asyringe, a fluid source, a mechanical actuator, an electric actuator,and/or the like. In other embodiments, the seal can be any othersuitable configuration.

The inner surface 223 of the first member 220 and the inner surface 233of the second member 230 collectively define the inner volume 213 of theintroducer 210. As shown in FIG. 12 , the arrangement of the innersurfaces 223 and 233 is such that the inner volume 213 has and/ordefines a tortuous cross-sectional shape. For example, the inner volume213 can have a substantially S-shaped or an at least partially S-shapedcross-sectional shape. More specifically, the inner surface 223 of thefirst member 220 includes and/or forms a ridge, tab, flange, protrusion,and/or wall configured to separate the first portion 224 of the innersurface 223 from the second portion 225 of the inner surface 223. Thus,the tortuous cross-sectional shape of the inner volume 213 forms and/ordefines a first portion 214 of the inner volume 213 and a second portion215 of the inner volume 213. In this manner, the first portion 214 ofthe inner volume 213 is spaced apart from the second portion 215 of theinner volume 213 without being fluidically isolated therefrom. In otherwords, the first portion 214 of the inner volume 213 defines an axisthat is parallel to and offset from an axis defined by the secondportion 215 of the inner volume 213.

As shown in FIG. 12 , the first portion 214 of the inner volume 213extend through a wall of the introducer 210. Similarly stated, theintroducer 210 defines (e.g., the first member 220 and the second member230 collectively define) a slot, channel, track, opening, and/or thelike that is in fluid communication with the first portion 214 of theinner volume 213. Conversely, the second portion 215 of the inner volume213 is entirely defined and/or enclosed (at least in the circumferentialdirection) by the introducer 210. The tortuous cross-sectional shape ofthe inner volume 213 is such that the second portion 215 cannot beviewed (e.g., is out of the line of sight) via the slot (in fluidcommunication with the first portion 214 of the inner volume 213), whichin turn, can limit and/or substantially prevent contamination of thecatheter 260 disposed therein.

In this embodiment, the second portion 215 of the inner volume 213 issubstantially aligned with, for example, a portion of the opening 217and a portion of an opening defined by the coupler 216. Moreover, thesecond portion 215 of the inner volume 213 is configured to besubstantially aligned with the lock 240 when the lock is coupled to thecoupler 216 of the introducer 210. In other words, the axis defined bythe second portion 215 of the inner volume 213 is substantially co-axialwith an axis defined by a portion of the lock 240, as described infurther detail herein. In this manner, the second portion 215 of theinner volume 213 can movably receive, for example, a portion of theactuator 270 and a portion of the catheter 260. Thus, the actuator 270can be moved relative to the introducer 210 to move the catheter 260between a first position, in which the catheter 260 is entirely disposedwithin the second portion 215 of the inner volume 213, and a secondposition, in which at least a portion of the catheter 260 extendsoutside of the second portion 215 of the inner volume 213 and distal tothe introducer 210, as described in further detail herein.

The lock 240 of the transfer device 200 can be any suitable shape, size,and/or configuration. As described above, the lock 240 is configured tobe physically and fluidically coupled to the introducer 210 andconfigured to couple the introducer 210 to the PIV and/or any suitableintermediate device or adapter coupled to the PIV. The lock 240 has acoupler 241, a proboscis 242, a first arm 243, and a second arm 250, asshown in FIGS. 13-15 . In addition, the lock 240 defines a lumen 255extending through the coupler 241 and the proboscis 242. The coupler 241is configured to couple the lock 240 to the coupler 216 of theintroducer 210. Specifically, in this embodiment, the coupler 241includes and/or forms one or more protrusions configured to selectivelyengage the threads defined and/or formed by the coupler 216 of theintroducer 210, thereby forming a threaded coupling.

The proboscis 242 extends from the coupler 246 and is disposed betweenthe first arm 243 and the second arm 250. The proboscis 242 can be anysuitable shape, size, and/or configuration. In some embodiments, theconfiguration of the proboscis 242 can be associated with or at leastpartially based on a size and/or shape of the PIV, a size and/or shapeof an adapter (e.g., an extension set, a Y-adapter, a T-adapter, or thelike), or a collective size and/or shape of the PIV and the adapter. Forexample, in some embodiments, the proboscis 242 can have a length thatis sufficient to extend through at least a portion of the PIV (oradapter). In embodiments including an adapter coupled to the PIV, theproboscis 242 can be sufficiently long to extend through the adapter andat least partially into or through the PIV. In some embodiments, theproboscis 242 can be sufficiently long to extend through an adapter andthe PIV such that at least a portion of the proboscis 242 is distal tothe PIV. Moreover, the proboscis 242 can have an outer diameter that issimilar to or slightly smaller than an inner diameter of a portion ofthe PIV and/or adapter coupled thereto. For example, in someembodiments, an outer surface of the proboscis 242 can be in contactwith an inner surface of the PIV when the proboscis 242 is disposedtherein. In this manner, the proboscis 242 can provide structuralsupport to at least a portion of the PIV within which the proboscis 242is disposed. Similarly, the proboscis 242 can have an inner diameter (adiameter of a surface at least partially defining the lumen 255) that issimilar to or slightly larger than an outer diameter of a portion of thecatheter 260, as described in further detail herein.

The first arm 243 and the second arm 250 of the lock 240 can be anysuitable shape, size, and/or configuration. As shown in FIGS. 13 and 14, the first arm 243 has a first end portion 244, a second end portion245 including a tab 246, and a pivot portion 247 disposed between thefirst end portion 244 and the second end portion 245. The tab 246disposed at and/or formed by the second end portion 245 extends from thesecond end portion 245 toward, for example, the proboscis 242. In thismanner, the tab 246 can selectively engage a portion of the PIV and/or aportion of an adapter coupled to the PIV to couple the lock 240 thereto,as described in further detail herein.

The pivot portion 247 of the first arm 243 extends from the coupler 241,proboscis 242, and/or second arm 250 in a lateral direction. The firstend portion 244 and the second end portion 245 of the first arm 243 areproximal to the pivot portion 247 and distal to the pivot portion 247,respectively. As such, the first arm 243 can act as a lever or the likeconfigured to pivot about an axis defined by the pivot portion 247 inresponse to an applied force. For example, in some instances, a user canexert a force on the first end portion 244 (e.g., toward the coupler241) that is sufficient to pivot the first end portion 244 of the firstarm 243 toward the coupler 241 (as indicated by the arrow AA in FIG. 14) and the second end portion 245 of the first arm 243 away from theproboscis 242 (as indicated by the arrow BB in FIG. 14 ), as describedin further detail herein.

As described above with reference to the first arm 243, the second arm250 of the lock 240 has a first end portion 251, a second end portion252 including a tab 253, and a pivot portion 254 disposed between thefirst end portion 251 and the second end portion 252. In thisembodiment, the first arm 243 and the second arm 250 are substantiallysimilar in form and function and are arranged in opposite positions andorientations relative to the coupler 241 and proboscis 242 (e.g., thelock 240 is substantially symmetrical about its longitudinal axis). Assuch, the discussion of the first arm 243 similarly applies to thesecond arm 250 and thus, the second arm 250 is not described in furtherdetail herein.

As described above, the lock 240 is configured to be coupled to the PIVand/or an adapter coupled to the PIV. For example, a user can exert alateral force on the first end portion 244 of the first arm 243 and thefirst end portion 251 of the second arm 250 to pivot the first arm 243and the second arm 250, respectively, from a first position toward asecond position. The pivoting of the first arm 243, therefore, increasesa space defined between the proboscis 242 and the second end portion 245(and the tab 246) of the first arm 243. Similarly, the pivoting of thesecond arm 250 increases a space defined between the proboscis 242 andthe second end portion 252 (and the tab 253) of the second arm 250. Inthis manner, the increased space between the proboscis 242 and the arms243 and 250 is sufficient to allow a portion of the PIV and/or anadapter coupled to the PIV to be inserted within the space. Once theportion of the PIV and/or the adapter is in a desired position relativeto the lock 240, the user can remove the force and in turn, the arms 243and 250 pivot toward their respective first positions. As a result, thesecond end portions 245 and 252 are moved toward the proboscis 242 untilthe tabs 246 and 253, respectively, are placed in contact with a portionof the PIV and/or the adapter. The tabs 246 and 253 are configured toengage the portion of the PIV and/or adapter to temporarily couple thelock 240 to the PIV and/or adapter. In some embodiments, the lock 240can be configured to establish three points of contact with the PIVand/or the adapter, namely, the tabs 246 and 253, and an outer surfaceof the proboscis 242 (as described above). In some embodiments, the tabs246 and 253 can be configured to produce an audible output such as aclick, a vibratory output such as a haptic bump, and/or the like whenplaced in contact with the portion of the PIV and/or adapter, which canindicate to a user that the lock 240 is properly coupled to the PIVand/or adapter.

As shown in FIG. 15 , the proboscis 242 and the coupler 241 collectivelydefine the lumen 255. The lumen 255 of the lock 240 defines an axis (notshown) that is aligned with and/or substantially co-axial with the axisdefined by the second portion 215 of the inner volume 213. Thus, thelumen 255 of the lock 240 receives a portion of the catheter 260 whenthe transfer device 200 is transitioned between the first configurationand the second configuration. In some embodiments, the lumen 255 canhave a size and/or shape that is based at least in part on a size and/orshape of the catheter 260. For example, the lumen 255 can have an innerdiameter that is slightly larger than an outer diameter of at least aportion of the catheter 260. In such embodiments, the lock 240 can beand external guide or the like that can support and/or guide thecatheter 260 as the catheter 260 is moved within the lumen 255, which inturn, can reduce and/or substantially prevent undesirable bending,kinking, flexing, and/or deforming of the catheter 260.

Although the lock 240 is shown and described above as including theproboscis 242, in other embodiments, a lock need not form a proboscis.For example, in some such embodiments, a lock can include a relativelyshort hub or the like configured to engage a portion of the PIV and/oran adapter coupled to the PIV. In some embodiments, a fluid transferdevice can include and/or can be used with a proboscis or guide member(not formed with or by the lock) configured to be disposed, for example,between a PIV and an adapter such as an IV extension set. For example,such a proboscis or guide member can have an inner surface that isfunnel shaped and/or is shaped similar to the inner surface of theproboscis 242. In this manner, the inner surface of such a proboscisand/or guide member can guide a portion of the catheter 260 as thecatheter 260 is moved between the first position and the secondposition. In some embodiments, the lock 240 (including the proboscis242) can be used in conjunction with such an external or separateproboscis and/or guide member. In some such embodiments, a portion ofthe proboscis 242 of the lock 240 can be inserted into the proboscisand/or guide member when the lock 240 is coupled to the adapter (e.g.,IV extension set).

As described above, at least a portion of the catheter 260 and at leasta portion of the secondary catheter 265 is movably disposed within thesecond portion 215 of the inner volume 213 defined by the introducer210. As shown in FIG. 16 , the catheter 260 has a proximal end portion261 and a distal end portion 262 and defines a lumen 263 (see e.g., FIG.24 ). The proximal end portion 261 of the catheter 260 is coupled to asecond portion 275 of the actuator 270. In this manner, the actuator 270can be moved relative to the introducer 210 to move the catheter 260between a first position, in which the catheter 260 is disposed withinthe introducer 210 (e.g., the entire catheter 260 is disposed within theintroducer 210 or within the introducer 210 and the lock 240) and asecond position, in which the distal end portion of the catheter 260 isat least partially disposed in a position distal to the lock 240 and/orthe PIV (not shown) when the lock 240 is coupled to the PIV, asdescribed in further detail herein. The distal end portion 262 can beany suitable shape, size, and/or configuration and can define at leastone opening in fluid communication the lumen 263. For example, in someembodiments, the distal end portion 262 of the catheter can besubstantially similar to any of those described in U.S. Pat. No.8,366,685 (referred to herein as the “'685 patent”) entitled, “Systemsand Methods for Phlebotomy Through a Peripheral IV Catheter,” filed onApr. 26, 2012, the disclosure of which is incorporated herein byreference in its entirety.

The catheter 260 can be any suitable shape, size, and/or configuration.For example, in some embodiments, at least a portion of the catheter 260can have an outer diameter that is substantially similar to or slightlysmaller than an inner diameter defined by the lumen 255 of the lock 240,as described above. In some embodiments, an outer surface of thecatheter 260 can be configured to contact an inner surface of the lock240 that defines at least a portion of the lumen 255. In this manner, aninner surface of the portion of the lock 240 defining the lumen 255 canguide the catheter 260 as the catheter 260 is moved between the firstposition and the second position. In some embodiments, such anarrangement can limit and/or can substantially prevent bending,deforming, and/or kinking of the catheter 260 as the catheter 260 ismoved between the first position and the second position. Moreover, insome embodiments, the catheter 260 can have a length that is sufficientto place a distal surface of the catheter 260 in a desired positionrelative to a distal surface of the PIV when the catheter 260 is in thesecond position. In other words, the length of the catheter 260 can besufficient to define a predetermined and/or desired distance between thedistal surface of the catheter 260 and the distal surface of the PIVwhen the catheter 260 is in the second position, as described in furtherdetail herein.

The catheter 260 can be formed from any suitable material or combinationof materials, which in turn, can result in the catheter 260 having anysuitable stiffness or durometer. For example, in some embodiments, thecatheter 260 can be formed of a relatively flexible biocompatiblematerial with a Shore durometer of approximately 20 Shore A to 50 ShoreD; approximately 20 Shore A to 95 Shore D; approximately 70 Shore D to85 Shore D, and/or any other suitable range of Shore durometer. In someembodiments, at least a portion of the catheter 260 can be formed of abraided material or the like, which can modify, change, and/or alter aflexibility of the catheter 260 in response to a bending force or thelike. In other words, forming at least a portion of the catheter 260from the braided material can increase an amount of deformation (inresponse to a bending force) of the catheter 260 prior buckling,kinking, and/or otherwise obstructing the lumen 263 of the catheter 260.Similarly, forming at least a portion of the catheter 260 of a braidedmaterial can result in a compression and/or deformation in response to acompression force exerted in a direction of a longitudinal centerlinedefined by the catheter 260 (e.g., an axial force or the like). In thismanner, the catheter 260 can absorb a portion of force associated with,for example, impacting an obstruction or the like. In some instances,such an arrangement can reduce buckling and/or kinking of the catheter260 as well as reduce and/or substantially prevent damage to vascularstructures that may otherwise result from an impact of the catheter 260.Moreover, in some embodiments, forming at least a portion of thecatheter 260 from the braided material, for example, can increase anamount of vibration transmitted through the catheter 260 in response tothe portion of the actuator 270 advancing along the set of ribs 236 ofthe introducer 210 (as described above). While the catheter 260 isdescribed above as including at least a portion formed of a braidedmaterial, in other embodiments, at least a portion of the catheter 260can be formed of and/or can include a support wire, a stent, afenestrated catheter, and/or the like such as those described in the'685 patent incorporated by reference above.

The secondary catheter 265 has a proximal end portion 266 and a distalend portion 267 and defines a lumen 268 (see e.g., FIG. 24 ). A portionof the secondary catheter 265 is disposed within and extends through theopening 217 of the introducer 210 (e.g., collectively defined by thenotches 223 and 233 of the first member 220 and second member 230,respectively). As such, the proximal end portion 266 is at leastpartially disposed outside of the introducer 210 and the distal endportion 267 is at least partially disposed within the second portion 215of the inner volume 213 defined by the introducer 210. As describedabove, the secondary catheter 265 can be moved within the opening 217between a first position and a second position to selectively clamp,pinch, kink, bend, and/or otherwise deform a portion of the secondarycatheter 265, which in turn, obstructs, pinches, kinks, closes, seals,etc. the lumen 268 of the secondary catheter 265. For example, the firstposition can be associated and/or aligned with a first portion of theopening 217 having a larger perimeter and/or diameter than a perimeterand/or diameter of a second portion of the opening 217 associated and/oraligned with the second position. Thus, a user can manipulate thesecondary catheter 265 to occlude the lumen 268 of the secondarycatheter 265, thereby limiting, restricting, and/or substantiallypreventing a flow of a fluid therethrough.

As shown in FIG. 16 , the proximal end portion 266 of the secondarycatheter 265 is coupled to and/or otherwise includes a coupler 269. Thecoupler 269 is configured to physically and fluidically couple thesecondary catheter 265 to any suitable device such as, for example, afluid reservoir, fluid source, syringe, evacuated container holder(e.g., having a sheathed needle or configured to be coupled to asheathed needle), pump, and/or the like. The distal end portion 267 ofthe secondary catheter 265 is at least partially disposed within thesecond portion 215 of the inner volume 213 defined by the introducer 210and is coupled to the second portion 275 of the actuator 270. In someembodiments, the secondary catheter 265 can have a larger diameter thanthe catheter 260 such that the proximal end portion 261 of the catheter260 is at least partially disposed within the lumen 268 defined by thesecondary catheter 265 when the catheter 260 and the secondary catheter265 are coupled to the second portion 275 of the actuator 270. In someembodiments, such an arrangement can, for example, reduce and/orsubstantially prevent leaks associated with fluid flowing between thecatheter 260 and the secondary catheter 265. In some embodiments, suchan arrangement can also limit, reduce, and/or substantially preventhemolysis of a volume of blood as the volume of blood flows through thecatheter 260 and the secondary catheter 265. In this manner, when thecoupler 269 is coupled to a fluid reservoir, fluid source, syringe,evacuated container, pump, etc., the secondary catheter 265 establishesfluid communication between the reservoir, source, pump, etc. and thecatheter 260.

The actuator 270 of the transfer device 200 is coupled to the catheter260 can be moved along a length of the introducer 210 to transition thetransfer device 200 between its first configuration, in which thecatheter 260 is in the first position, and its second configuration, inwhich the catheter 260 is in the second position. The actuator 270 canbe any suitable shape, size, and/or configuration. For example, in someembodiments, the actuator 270 can have a size and shape that isassociated with and/or based at least in part on a size and/or shape ofthe introducer 210.

As shown in FIGS. 17-20 , the actuator 270 includes a first portion 271,the second portion 275, and a wall 277 extending therebetween. The firstportion 271 of the actuator 270 is at least partially disposed withinthe first portion 214 of the inner volume 213 defined by the introducer210 and the second portion 275 of the actuator 270 is disposed withinthe second portion 215 of the inner volume 213, as described above. Thefirst portion 271 of the actuator 270 includes an engagement member 272.The arrangement of the actuator 270 is such that the engagement member272 is disposed outside of the introducer 210 while the rest of thefirst portion 271 is within the first portion 214 of the inner volume213 defined by the introducer 210. As such, the engagement member 272can be engaged and/or manipulated by a user (e.g., by a finger or thumbof the user) to move the actuator 270 relative to the introducer 210. Insome embodiments, the engagement member 272 can include a set of ridgesand/or any suitable surface finish that can, for example, increase theergonomics of the actuator 270 and/or transfer device 200.

The engagement member 272 includes a tab 273 disposed at or near aproximal end portion of the engagement member 272. The tab 273 can beany suitable tab, rail, ridge, bump, protrusion, knob, roller, slider,etc. that extends from a surface of the engagement member 272. The tab273 is configured to selectively engage the outer surface 235 of thesecond member 230 of the introducer 210. More specifically, the tab 273is in contact with the ribs 236 formed by the second member 230 andmoves along each successive rib as the actuator 270 is moved along alength of the introducer 210.

As described above with reference to the set of ribs 236 of the secondmember 230, the tab 273 can have any suitable shape, size, and/orconfiguration. For example, as shown in FIG. 18 , the tab 273 caninclude a substantially rounded surface that can be moved along the setof ribs 236. In some embodiments, the size and/or shape of the tab 273is based at least in part on a size and/or shape of the ribs 236 suchthat a desired surface area of the tab 273 is in contact with the ribs236 as the actuator 270 is moved relative to the introducer 210. In someembodiments, an amount of friction defined between the set of ribs 236and the tab 273 can be based at least in part on a surface area of thetab 273 that is in contact with the set of ribs 236. Moreover, an amountof friction defined between the set of ribs 236 and the tab 273 can bebased at least in part on a position of the tab 273 relative to eachrib. For example, in some embodiments, an amount of friction definedbetween the tab 273 and a rib can increase at the tab 273 moves closerto, for example, a local maxima and can decrease as the tab 273 movesaway from the local maxima. In some embodiments, the tab 273 can have asize and/or shape that allows the tab 273 to move with substantiallyless friction between each adjacent rib (e.g., between adjacent localmaximums). In other words, the arrangement of the tab 273 and the set ofribs 236 can allow for a desired amount of “play” between adjacent ribs.

With the first portion 237 of the set of ribs 236 having a smaller sizethan the second portion 238 of the set of ribs 236, a first portion orfirst surface area of the tab 273 can be in contact with the firstportion 237 of the set of ribs 236 and a second portion or secondsurface area of the tab 273 can be in contact with the second portion238 of the set of ribs 236. In this manner, the tab 273 can move alongthe first portion 237 with a first set of characteristics and can movealong the second portion 238 with a second set of characteristicsdifferent from the first set of characteristics. In some embodiments,for example, a force sufficient to move the tab 273 along the secondportion 238 of the set of rib 236 can be greater than a force otherwisesufficient to move the tab 273 along the first portion 237 of the set ofribs 236. In some embodiments, the movement of the tab 273 along thesecond portion 238 of the set of ribs 236 can result in, for example, alarger amount of vibration of the actuator 270 than an amount ofvibration otherwise resulting from the movement of the tab 273 along thefirst portion 237 of the set of ribs 236. Similarly, the shape of thetab 273 can be such that the tab 273 moves along the set of ribs 236 inthe distal direction in response to an applied force that isinsufficient to move the tab 273 along the set of ribs 236 in theproximal direction. For example, as shown in FIG. 18 , the tab 273 hasan asymmetric shape, wherein a proximal surface of the tab 273 has agreater pitch than a pitch of its distal surface.

While the engagement member 272 and tab 273 are particularly shown anddescribed above, in other embodiments, an actuator can include anengagement member and/or tab having any suitable configuration. Forexample, while the tab 273 is shown as being disposed at or near aproximal end portion of the engagement member 272, in other embodiments,an engagement member can include a first tab disposed at or near aproximal end portion and a second tab disposed at or near a distal endportion, each of which can be selectively in contact with a set of ribsdisposed on an outer surface of an introducer. In some embodiments, aspace defined between a surface of the wall 277 and a surface of theengagement member 272 can be increased or decreased, which can result inan increase or decrease in an amount of travel of the actuator 270relative to the introducer 210 in a direction other than an axialdirection. That is to say, the increase or decrease in space between thesurface of the wall 277 and a surface of the engagement member 272 canresult in, for example, an increase or decrease of an amount theactuator 270 can “tilt” relative to the introducer 210. In otherembodiments, the arrangement of the engagement member 272, the tab 273,and/or the set of ribs 236 of the introducer 210 can be modified,altered, tuned, adjusted, and/or otherwise changed such that theactuator 270 moves relative to the introducer 210 with a desired set ofcharacteristics. For example, in some embodiments, the arrangement ofthe actuator 270 and/or introducer 210 can increase or decrease anamount the actuator 270 vibrates as it is moved relative to theintroducer 210, increase or decrease an amount of force sufficient tomove the actuator 270 relative to the introducer 210, increase ordecrease an amount of movement of the actuator 270 relative to theintroducer 210 in any suitable direction other than the axial direction(e.g., proximal direction or distal direction), and/or the like.

As shown, for example, in FIGS. 19 and 20 , the second portion 275 has across-sectional shape that is based at least in part on across-sectional shape of the second portion 215 of the inner volume 213defined by the introducer 210 (e.g., at least a partially circularcross-sectional shape). In this manner, the inner surface 223 of thefirst member 220 and the inner surface 233 of the second member 230 cansupport and/or guide the second portion 275 of the actuator 270 as theactuator 270 moves relative to the introducer 210. As shown, the secondportion 275 defines an opening 276 configured to receive a proximal endportion 261 of the catheter 260 and a distal end portion 267 of thesecondary catheter 265. In some embodiments, the proximal end portion261 of the catheter 260 can form a friction fit with an inner surface ofthe second portion 275 of the actuator 270 when the proximal end portion261 is disposed in the opening 276. Similarly, the distal end portion267 of the secondary catheter 265 can form a friction fit with an innersurface of the second portion 275 of the actuator 270 when the distalend portion 267 is disposed in the opening 276. As such, the catheter260 and the secondary catheter 265 can be maintained in a fixed positionrelative to the actuator 270 and thus, move concurrently with theactuator 270 as the actuator 270 is moved relative to the introducer210.

The wall 277 of the actuator 270 couples the first portion 271 of theactuator 270 to the second portion 275 of the actuator 270. As shown inFIGS. 19 and 20 , the wall 277 has a tortuous cross-sectional shape thatis based at least in part on the tortuous cross-sectional shape of theinner volume 213 defined by the introducer 210. In this manner, thefirst portion 271 of the actuator 270 can define an axis that isparallel to but offset from an axis defined by the second portion 275 ofthe actuator 270. In some embodiments, for example, the wall 277 canhave a substantially S-shaped or an at least partially S-shapedcross-sectional shape. In some embodiments, the wall 277 can form, forexample, a dogleg or the like. The tortuous cross-sectional shape of thewall 277 (and thus, the actuator 270) is such that the second portion275 of the actuator 270 cannot be viewed (e.g., is out of the line ofsight) via the first portion 214 of the inner volume 213 defined by theintroducer 210. Similarly, the catheter 260 cannot be viewed via thefirst portion 214 of the inner volume 213 defined by the introducer 210when the catheter 260 is in the first position. That is to say, thegeometry of the actuator 270 and/or the introducer 210 (e.g., thetortuous cross-sectional shape of the inner volume 213, the heightand/or width of the introducer 210, etc.) is configured such that thecatheter 260 is at least partially isolated within the second portion215 of the inner volume 213 when the catheter 260 is in the firstposition. In this manner, the structure of the introducer 210 and/or theactuator 260 can protect and/or isolate the catheter 260 from a volumeoutside of the introducer 210, which in turn, can limit and/orsubstantially prevent contamination of the catheter 260. For example, insome embodiments, the introducer 210 and/or the actuator 270 can act asa “sneeze guard” or the like configured to at least partially isolatethe catheter 260 at least when the catheter 260 is in the firstposition.

Referring now to FIGS. 21-29 , the transfer device 200 can be in thefirst configuration prior to use and can be transitioned by a user(e.g., a doctor, physician, nurse, technician, phlebotomist, and/or thelike) from the first configuration (FIGS. 21-24 ) to the secondconfiguration (FIGS. 27-29 ) to dispose at least the distal end portion262 of the catheter 260 in a distal position relative to the introducer210 (e.g., within an indwelling PIV (not shown) or distal to theindwelling PIV). The transfer device 200 is in the first configurationwhen the catheter 260 is disposed in the first position 260 within theintroducer 210. In some embodiments, substantially the entire catheter260 is disposed within the introducer 210 when the catheter 260 is inthe first position. In such embodiments, the introducer 210 can includethe seal or the like (as described above) that can substantially sealthe distal end portion 212 of the introducer 210 to isolate the catheter260 within the second portion 215 of the inner volume 213. In theembodiment shown in FIGS. 22 and 23 , however, the catheter 260 isdisposed within the introducer 210 and the lock 240 when catheter 260 isin the first position. While the seal is described above as beingincluded in the distal end portion 212 of the introducer 210, in otherembodiments, the lock 240 can include a seal or the like that can form asubstantially fluid tight seal with an inner surface of the lock 240that defines the lumen 243. Thus, the seal disposed within the lock 240can isolate the catheter 260 within the second portion 215 of the innervolume 213. In still other embodiments, the introducer 210 and/or thelock 240 need not include a seal. For example, in some embodiments, aPIV and/or an adapter (e.g., extension set) coupled to the PIV caninclude a seal that is transitioned from a closed configuration to anopen configuration when the lock 240 is coupled thereto. Although notshown, in some embodiments, the catheter 260 can be disposed within aflexible sheath or the like that can maintain the catheter 260 in asubstantially sterile environment while the catheter 260 is in the firstposition (e.g., such as those embodiments in which the introducer 210and/or lock 240 do not include a seal).

The actuator 270 is disposed in a proximal position when the transferdevice 200 is in the first configuration, as shown in FIG. 24 . In someembodiments, the tab 273 of the first portion 271 of the actuator 270can be disposed within a recess or detent or otherwise in contact with aproximal most rib configured to temporarily maintain the actuator 270 inthe proximal position until a force is exerted (e.g., by the user) tomove the actuator 270 in the distal direction. Moreover, as describedabove, a portion of the secondary catheter 265 is disposed in theopening 217 defined by the introducer such that the distal end portion267 is at least partially disposed in the second portion 215 of theinner volume 213 and coupled to the second portion 275 of the actuator270 while the proximal end portion 266 of the secondary catheter 265 isdisposed outside of the introducer 210 (see e.g., FIGS. 21 and 22 ).

With the transfer device 200 in the first configuration, the user canmanipulate the transfer device 200 to couple the lock 240 to anindwelling PIV and/or to an adapter coupled to the PIV (e.g., anextension set or the like). For example, in some embodiments, the usercan exert a force sufficient to pivot the first arm 243 and the secondarm 250 of the lock 240 such that a portion of the PIV and/or theadapter can be inserted into the space defined between the arms 243 and250 and, for example, the proboscis 242. In some embodiments, theproboscis 242 can be inserted into the PIV and/or the adapter when thelock 240 is coupled thereto. For example, in some embodiments, a portionof the proboscis 242 can be inserted into a hub or basket of the PIVand/or adapter. As described above, in some embodiments, the proboscis242 that is sufficiently long to dispose at least a portion of theproboscis 242 within the PIV, which in turn, supports and/or providesstructural rigidity to the PIV. Once the PIV and/or adapter is disposedin the desired position relative to the lock 240, the user can removethe force on the arms 243 and 250 of the lock 240, which in turn, movetoward proboscis 242 until the tab 246 of the first arm 243 and the tab253 of the second arm 250 are placed in contact with a surface of thePIV and/or adapter. In some embodiments, the arrangement of the lock 240is such that the tabs 246 and 253 and the proboscis 242 form threepoints of contact with the PIV and/or adapter that collectively coupledthe lock 240 thereto.

With the transfer device 200 coupled to the PIV and/or adapter, the usercan engage the engagement member 272 of the first portion 271 of theactuator 270 to move the actuator 270 relative to the introducer 210,which in turn, moves the catheter 260 from the first position (e.g.,disposed within the introducer 210) toward the second position. In thismanner, the catheter 260 is moved through the second portion 215 of theinner volume 213 and the lumen 255 of the lock 240 and as such, at leastthe distal end portion 262 of the catheter 260 is disposed outside ofand distal to the lock 240, as indicated by the arrow CC in FIG. 25 . Insome embodiments, the arrangement of the lumen 255 of the lock 240 andthe catheter 260 can be such that an inner surface of the lock 240defining the lumen 255 contacts, supports, and/or otherwise guides thecatheter 260 as the catheter 260 is moved in the distal direction towardthe second position. Moreover, in some embodiments, moving the catheter260 from the first position toward the second position can be operableto transition the seal (e.g., disposed in the lock 240) from a closed orsealed configuration to an open configuration. In other embodiments, theuser can manipulate the transfer device 200 (e.g., prior to moving thecatheter 260 from the first position) to transition the seal from thesealed configuration to the open configuration. For example, in someembodiments, the user can increase a pressure within at least a portionof the transfer device 200 (e.g., the catheter 260 and/or the lock 240)beyond a predetermined threshold to transition the seal to the openconfiguration. In some embodiments, the seal can be a one way valve(e.g., a positive pressure valve or seal) that can be transitioned fromthe sealed configuration to the open configuration, for example, when apressure exerted on a proximal portion of the seal exceeds a pressureexerted on a distal portion of the seal (e.g., venous pressure exertedon the seal).

As described above, the arrangement of the actuator 270 and theintroducer 210 is such that advancing the actuator 270 relative to theintroducer 210 advances the tab 273 along the outer surface 235 and morespecifically, the set of ribs 236 of the second member 230 of theintroducer 210. As shown, for example, in FIG. 26 , the tab 273 is incontact with the set of ribs 236, which can produce a vibration of theactuator 270 as the actuator 270 is moved relative to the introducer210. In some instances, the vibration of the actuator 270 can produce,for example, a haptic, tactile, and/or audible output that can providean indication associated with a position of the distal end portion 262of the catheter 260 relative to the introducer 210, lock 240, and/orPIV. For example, in some embodiments, the tab 273 of the actuator 270and the set of ribs 236 can collectively produce a “click” sound as thetab 273 moves past each rib. In some embodiments, the introducer 210 caninclude indicia or the like that can indicate to the user the relativeposition of the distal end portion 262 of the catheter 260. In otherembodiments, the amount of times the actuator 270 has vibrated due tobeing moved relative to that number of ribs can be associated withand/or otherwise provide an indication of the relative position of thedistal end portion 262 of the catheter 260.

In some instances, the user can stop moving the actuator 270 relative tothe introducer 210 based on the haptic, tactile, and/or audible outputindicating a desired placement of the distal end portion 262 of thecatheter 260 relative to the PIV (e.g., the second position). In otherwords, the catheter 260 can be placed in the second position prior tothe actuator 270 being advanced, for example, to a distal most position.As described in further detail herein, the catheter 260 is disposed inthe second position when the distal end portion 262 of the catheter 260is placed in a desired position relative to a distal end portion of thePIV. In some instances, for example, a distal end of the catheter 260can be substantially flush with a distal end of the PIV when thecatheter 260 is in the second position. In other instances, the distalend of the catheter 260 can extend a predetermined distance beyond thedistal end of the PIV (e.g., distal to the distal end of the PIV). Instill other instances, the distal end of the catheter 260 can bedisposed within the PIV (e.g., proximal to the distal end of the PIV)when the catheter 260 is in the second position.

As shown in FIGS. 27-29 , in some instances, the catheter 260 can be inthe second position when the actuator 270 is in a distal most position.In this manner, the distal surface of the catheter 260 is positionedwithin the vein at a predetermined distance beyond the distal surface ofthe catheter 260. In some instances, placing the distal surface of thecatheter 260 the predetermined and/or desired distance from the distalsurface of the PIV can, for example, place the distal surface of thecatheter 260 in a position within a vein that is substantially free fromdebris (e.g., fibrin/blood clots) otherwise surrounding the distal endportion of the PIV.

In some instances, the indwelling PIV can substantially occlude at leasta portion of the vein within which the PIV is disposed. As such, PIVsare often suited for delivering a fluid rather than aspirating blood.The venous system, however, is a capacitance system and thus, reroutesblood flow through a different vein (e.g., forms a bypass around theocclusion or substantial occlusion). Moreover, the alternate venousstructure typically rejoins the vein in which the PIV is disposed at agiven distance downstream of the PIV and thus, delivers at least portionof the flow of blood that would otherwise be flowing through the vein inwhich the PIV is disposed. Similarly, veins typically have many branchvessels coupled to thereto that similarly deliver a flow of blood to thevein within which the PIV is disposed.

As such, in some instances, the predetermined and/or desired distancebetween the distal surface of the catheter 260 and the distal surface ofthe PIV can be sufficient to place the distal surface of the catheter260 downstream of one or more branch vessels in fluid communication withthe vein within which the PIV is disposed. In other words, the distalsurface of the catheter 260 can extend beyond the distal surface of thecatheter 260 such that at least one branch vessel is disposed betweenthe distal surface of the catheter 260 and the distal surface of the PIVwhen the catheter 260 is in the second position. Therefore, with thelumen 263 of the catheter 260 extending through the proximal end portion261 and the distal end portion 262 of the catheter 260, placing thedistal surface of the catheter 260 the predetermined and/or desireddistance from the distal surface of the PIV places the lumen 263 of thecatheter 260 in fluid communication with a portion of the vein receivinga substantially unobstructed or unrestricted flow of blood (e.g.,unobstructed by the PIV and/or debris associated with the indwelling ofthe PIV).

In some instances, for example, the predetermined and/or desireddistance can be between about 0.0 millimeters (e.g., the distal surfacesare flush) and about 100 millimeters (mm). In other embodiments, thepredetermined and/or desired distance can be between about 10 mm andabout 90 mm, between about 20 mm and about 80 mm, between about 30 mmand about 70 mm, between about 30 mm and about 60 mm, between about 40mm and about 50 mm, or between any other suitable range or subrangestherebetween. In some embodiments, for example, the transfer device 200can be configured such that the actuator 270 can move about 95 mm alongthe introducer 210 (e.g., the transfer device 200 has a 95 mm stroke) toposition the distal surface of the catheter 260 at about 40 mm beyondthe distal surface of the PIV to which the transfer device 200 iscoupled. In other embodiments, for example, the transfer device 200 canhave a 47 mm stroke that positions the distal surface of the catheter260 at about 20 mm beyond the distal surface of the PIV to which thetransfer device 200 is coupled. In still other embodiments, the transferdevice 200 can have any suitable stroke length to position the distalsurface of the catheter 260 at the predetermined and/or desired distancefrom the distal surface of the PIV.

Although the predetermined and/or desired distance is described above asbeing a positive distance, that is, the distal surface of the catheter260 is distal to the distal surface of the PIV, in other embodiments,the predetermined and/or desired distance can be associated with thedistal surface of the catheter 260 being in a proximal position relativeto the distal surface of the PIV (e.g., a negative distance). Forexample, in some instances, the predetermined and/or desired distancecan be between about 0.0 mm (e.g., the distal surfaces are flush) toabout −50 mm, between about −10 mm and about −40 mm, between about −20mm and about −30 mm, or between any other suitable range or subrangestherebetween. In some instances, the predetermined and/or desireddistance can be less than −50 mm (e.g., the distal surface of thecatheter 260 is more than 50 mm proximal to the distal surface of thePIV). In some instances, the catheter 260 can be placed in the secondposition such that the distal end portion 262 of the catheter 260remains within the PIV in a position distal to, for example, a kink orthe like. For example, in some instances, indwelling PIVs can have oneor more portions that are kinked such as a portion of the PIV where theperipheral intravenous catheter couples to a hub. In such instances, thepredetermined and/or desired distance can be such that the distalsurface of the catheter 260 is distal to the portion of the PIV thatforms the kink (e.g., where the peripheral intravenous catheter couplesto the hub). In some such instances, placing the distal surface of thecatheter 260 distal to the kinked portion of the PIV but remainingwithin the PIV can result in a fluid flow path being sufficientlyunrestricted to allow blood to be aspirated through the catheter 260.

With the catheter 260 in the second position (e.g., with the transferdevice 200 in the second configuration shown, for example, in FIGS. 25and 26 or FIGS. 27-29 ), the user can establish fluid communicationbetween a fluid reservoir, fluid source, syringe, and/or the like andthe catheter 260. For example, as described above, in some embodiments,the user can physically and fluidically couple the coupler 269 of thesecondary catheter 265 to a fluid reservoir, fluid source, syringe,and/or the like. Although described as establishing fluid communicationbetween the catheter 260 and the fluid reservoir or fluid source afterplacing the catheter 260 in the second position, in other embodiments,the user can establish fluid communication between the catheter 260 andthe fluid reservoir or fluid source prior to moving the actuator 270relative to the introducer 210. With the catheter 260 in fluidcommunication with the fluid reservoir and/or fluid source, the transferdevice 200 can then transfer a fluid from the patient or transfer afluid to the patient via the catheter 260 extending through and beyondthe PIV. For example, in some instances, the user can physically andfluidically couple the transfer device 200 to a fluid reservoir,evacuated container, syringe, and/or the like and then can aspirate avolume of blood from the vein based at least in part on disposing thedistal surface of the catheter 260 at the predetermined and/or desireddistance beyond the distal surface of the PIV.

In other instances, the user can physically and fluidically coupled thetransfer device 200 to a fluid source or the like and then can deliver avolume of fluid from the fluid source to a portion of the vein at aposition downstream of the PIV that receives a substantially uninhibitedand/or unrestricted flow of blood. In some instances, disposing thedistal surface of the catheter 260 at the predetermined and/or desireddistance beyond the distal surface of the PIV, for example, can reducepotential harm associated with infusion of caustic drugs. For example,by positioning the distal surface of the catheter 260 within a portionof the vein receiving a flow of blood that would otherwise be inhibitedand/or restricted by the indwelling PIV, the caustic drug can beentrained in the flow of blood and delivered to the target location. Assuch, a volume of the caustic drug is not retained within the debris orotherwise disposed in a position within the vein receiving little bloodflow.

In some instances, once a desired amount of blood has been collectedand/or once a desired volume of a drug has been delivered to thepatient, the user can move the actuator 270 in the proximal direction,thereby placing the transfer device 200 in a third (used) configuration.In the third configuration, the catheter 260 can be disposed within theintroducer 210 (e.g., distal to the seal or the like) and isolatedtherein. For example, in some embodiments, the actuator 270 can beplaced in it proximal most position, in which the catheter 260 is in thefirst position. Moreover, once the actuator 270 and catheter 260 are inthe desired position, the user can, for example, manipulate thesecondary catheter 265 within the opening 217 such that a surface of theintroducer 210 that defines the smaller portion of the opening 217contacts and clamps the secondary catheter 265. As such, the lumen 268of the secondary catheter 265 can be substantially obstructed, occluded,blocked, pinched, etc. to limit and/or substantially prevent a flow offluid therethrough. In some instances, clamping the secondary catheter265 as described, for example, can reduce and/or substantially preventfluid from leaking through the secondary catheter 265. In someinstances, the transfer device 200 can then be decoupled from the fluidreservoir, fluid source, syringe, etc. and safely discarded.

FIG. 30 is a flowchart illustrating a method 10 of using a fluidtransfer device to transfer a fluid through a peripheral intravenousline, according to an embodiment. The method includes coupling a lock ofthe fluid transfer device to an indwelling peripheral intravenous line(PIV), at 11. The fluid transfer device can be any suitable deviceconfigured for fluid transfer through a PIV. For example, in thisembodiment, the fluid transfer device can be substantially similar tothe fluid transfer device 200 described above with reference to FIGS.3-29 . As such, the fluid transfer device includes an introducer coupledto the lock, a catheter movably disposed in the introducer, and anactuator coupled to the catheter and in contact with an outer surface ofthe introducer. In some embodiments, the introducer includes a firstmember and a second member that collectively form the introducer. Insuch embodiments, the second member can have an outer surface thatdefines a set of ribs or the like, as described above with reference tothe second member 230 in FIGS. 7-12 . In this manner, the actuator canbe in contact with the ribs formed by the second member of theintroducer. Moreover, as described above with reference to the transferdevice 200, the introducer can define an inner volume having a tortuouscross-sectional shape configured to at least partially isolate thecatheter disposed in the inner volume from a volume outside of theintroducer.

With the lock coupled to the PIV (and/or an adapter coupled to the PIV),the actuator is moved relative to the introducer to advance the catheterfrom a first position, in which the catheter is disposed within at leastone of an inner volume defined by the introducer or the lock, toward asecond position, in which at least a portion of the catheter is disposedbeyond at least a portion of the PIV, at 12. In this manner, thecatheter can be advanced, for example, in the distal direction. In someembodiments, the lock can include an inner surface that defines a lumenconfigured to receive the catheter as the catheter is moved toward thesecond position. In some embodiments, the inner surface of the lock cancontact, support, and/or otherwise guide the catheter as the catheter ismoved in the distal direction toward the second position.

As described above with reference to the transfer device 200 in someembodiments, the arrangement of the actuator and the introducer is suchthat advancing the actuator relative to the introducer advances aportion of the actuator along the ribs formed by the outer surface ofthe introducer. In some embodiments, moving the actuator along the ribscan produce a vibration of the actuator, which in turn, can produce, forexample, a haptic, tactile, and/or audible output. Thus, an indicationassociated with a position of a distal end portion of the catheter asthe actuator moves the catheter from the first position toward thesecond position is provided to the user, at 13. For example, in someembodiments, the actuator and the set of ribs can collectively produce a“click” sound, a haptic vibration, and/or the like. In some embodiments,the introducer can include indicia or the like that can indicate to theuser the relative position of the distal end portion of the catheter. Inother embodiments, the amount of times the actuator has vibrated due tobeing moved along the ribs can be associated with and/or otherwiseprovide an indication of the relative position of the distal end portionof the catheter.

Based at least in part on the indication, the catheter is placed in thesecond position such that the distal end portion of the catheter isdisposed at a predetermined and/or desired distance beyond at least aportion of the PIV (e.g., beyond a distal surface of the PIV), at 14.For example, the catheter can be placed in the second position aftermoving the actuator at least a portion of the length of the introducer.In some embodiments, the catheter can be disposed in the second positionwhen the actuator is placed in a distal most position. As describedabove with reference to the transfer device 200, in some instances, thepredetermined and/or desired distance beyond the portion of the PIV canposition a distal surface of the catheter within a portion of the veinthat is substantially free from debris (e.g., fibrin/blood clots)otherwise surrounding a distal end portion of the PIV. Similarly, insome instances, disposing the distal end portion of the catheter at thepredetermined and/or desired distance from, for example, the distal endportion of the PIV can place the lumen of the catheter in fluidcommunication with a portion of the vein receiving a substantiallyunobstructed or unrestricted flow of blood (e.g., unobstructed by thePIV and/or debris associated with the indwelling of the PIV), asdescribed in detail above. In this manner, a user can couple thetransfer device to a fluid reservoir and/or fluid source to transferfluid from and/or to, respectively, the patient.

Although not shown in FIGS. 1 and 2 with reference to the transferdevice 100 or FIGS. 3-29 with reference to the transfer device 200, thetransfer devices 100 and 200 can be coupled to any suitable peripheralintravenous line (PIV). In some instances, use of a PIV can includecoupling the PIV to an IV extension set and/or an adapter (e.g., asingle port adapter, a Y-adapter, a T-adapter, or the like). Thus, whilethe transfer devices 100 and 200 are described herein as being coupledto a PIV, it should be understood that the transfer devices 100 and 200can be coupled to either a PIV or an adapter coupled thereto based onthe situation and/or configuration. The transfer devices 100 and 200 canbe configured to couple to any suitable commercially available PIV,adapter, and/or extension set. For example, while the first arm 243 andthe second arm 250 of the lock 240 are shown (e.g., in FIGS. 13 and 14 )and described above as having a given shape and/or configuration, inother embodiments, a lock can include a first arm and a second arm thathave a size, shape, and/or configuration that can allow the lock to becoupled to various PIVs, adapters, and/or extension sets. By way ofexample, in some embodiments, the arms of a lock can be rounded, bent,bowed, widened, and/or the like to allow the lock to receive a portionof any suitable PIV, adapter, and/or extension set. In some embodiments,the arrangement of the arms 243 and 250 of the lock 240 can allow thelock 240 to be rotated substantially 360° about any suitable PIV,adapter, and/or extension set when coupled thereto. Moreover, while theproboscis 242 is shown and described above as having a particular sizeand/or shape, in other embodiments, a lock can include a proboscis thathas any suitable length (e.g., longer or shorter than the proboscis242), width (e.g., wider or narrower than the proboscis 242), and/orshape (e.g., curved, tapered, flared, etc.). In some embodiments, aproboscis can have a surface finish or feature such as one or morethreads, flighting (e.g., an auger flighting), ribs, grooves, and/or thelike.

The embodiments described herein can be used to transfer fluid from apatient or to the patient by accessing a vein via an indwelling PIV. Asdescribed above, the transfer devices 100 and/or 200, for example, canbe manipulated to place a distal surface of a catheter at apredetermined and/or desired distance from a distal surface of the PIV.In some instances, the embodiments described herein allow for efficientblood draw while maintaining the integrity of the sample. Whileextracting blood, the transfer devices 100 and/or 200 can be configuredto receive and/or produce a substantially laminar (e.g., non-turbulentor low turbulent) flow of blood through the transfer device 100 and/or200, respectively, to reduce and/or substantially prevent hemolysis ofthe blood as the blood flows through the transfer devices 100 and/or200, respectively.

While the embodiments described herein can be used in a variety ofsettings (ER, in-patient, etc.), the following scenario of withdrawing asample volume of blood from a patient is provided by way of example. Insome instances, for example, a peripheral intravenous line and/orcatheter (PIV) is inserted into a vein of a patient following standardguidelines and an extension set and/or adapter is attached. The PIV canremain within the vein for an extended period and can provide access tothe vein for the transfer of fluids (e.g., saline, blood, drugcompounds, etc.) to the patient. When it is time to draw blood, a user(e.g., nurse, physician, phlebotomist, and/or the like) can stop thetransfer of fluid to the patient, if it is transferring fluid, forapproximately 1-5 minutes to allow the fluid to disperse from theblood-drawing site. To draw the blood sample, the user attaches atransfer device (e.g., the transfer devices 100 and/or 200) to a portand/or suitable portion of the extension set and/or adapter andtransitions the transfer device to from a first configuration (e.g., astorage configuration) to a second configuration, in which a portion ofa catheter included in the transfer device extends through theperipheral IV and into the vein.

As described in detail above with reference to the transfer device 200,an end of the catheter can be disposed at a predetermined and/or desireddistance from an end of the PIV when the transfer device is in thesecond configuration to place the catheter in fluid communication with aportion of the vein that receives an unobstructed and/or uninhibitedflow of blood. For example, the end of the catheter can be in a distalposition relative to the end portion of the PIV and at least one branchvessel, valve, and/or the like in fluid communication with the vein.Once the catheter is in the desired position, the user can attach one ormore negative pressure collection containers, tubes, and/or syringes tothe transfer device to extract a volume of blood. In some instances, thevolume of blood can be a first volume of blood that can be discardedand/or at least temporarily stored apart from a subsequent sample volumeof blood (e.g., typically a volume of about 1-3 milliliters (mL) but upto 8-10 mL of blood can be a “waste” or “pre-sample” volume). In someinstance, the waste volume can include contaminants, non-dispersedresidual fluids, and/or the like. After the collective of the wastevolume, the user can couple one or more negative pressure containers(e.g., sample containers) to the transfer device to collect a desiredblood sample volume. Once the sample volume is collected, the transferdevice can be transitioned from the second configuration toward thefirst configuration and/or a third configuration (e.g., a “used”configuration). The transfer device can then be decoupled from theextension set and/or adapter and safely discarded. In some instances,after collecting the sample volume but prior to transitioning thetransfer device from the second configuration, the waste or pre-samplevolume, for example, can be reinfused into the vein.

In some instances, the transfer devices described herein can beassembled during one or more manufacturing processes and packaged in apre-assembled configuration. For example, in some instances, thetransfer device 200 can be assembled by coupling the catheter 260 andthe secondary catheter 265 to the actuator 270; positioning the catheter260, secondary catheter 265, and actuator 270 relative to the firstmember 220 or second member 230 of the introducer 210; coupling thefirst member 220 and the second member 230 to form the introducer 210with the actuator 270 and at least a portion of the catheter 260 andsecondary catheter 265 disposed in the inner volume 213 of theintroducer 210; and coupling the lock 240 to the introducer 210. In someinstances, the assembly of the transfer device 200 can be performed in asubstantially sterile environment such as, for example, an ethyleneoxide environment, or the like. In other embodiments, the transferdevices described herein can be packaged in a non-assembledconfiguration (e.g., a user can open the package and assemble thecomponents to form the transfer device). The components of the transferdevices can be packaged together or separately. In some embodiments, thetransfer devices can be packaged with, for example, a PIV, an extensionset, a Y-adapter or T-adapter, and/or any other suitable component.

While various embodiments have been described above, it should beunderstood that they have been presented by way of example only, and notlimitation. Where schematics and/or embodiments described above indicatecertain components arranged in certain orientations or positions, thearrangement of components may be modified. Although various embodimentshave been described as having particular features and/or combinations ofcomponents, other embodiments are possible having a combination of anyfeatures and/or components from any of embodiments as discussed above.

While the embodiments have been particularly shown and described, itwill be understood that various changes in form and details may be made.For example, while the transfer device 200 is shown and described aboveas including the catheter 260 and the secondary catheter 265, each ofwhich being coupled to the actuator 270, in other embodiments, thetransfer device 200 can include a single catheter (e.g., the catheter260). For example, in some embodiments, at least the second portion 275of the actuator 270 can be configured to transition between an openconfiguration and a closed configuration. In such embodiments, thecatheter 260 can be placed in a desired position relative to the secondportion 275 when the second portion 275 is in the open configuration.The second portion 275 can then be transitioned from the openconfiguration to the closed configuration to retain at least a portionof the catheter 260 within the opening 276 defined by the second portion275. In such embodiments, the second portion 275 and the portion of thecatheter 260 disposed in the opening 276 can form a friction fitoperable to retain the catheter 260 in a fixed position relative to theactuator 270. Moreover, the friction fit defined between the secondportion 275 of the actuator 270 and the catheter 260 can isolate aportion of the catheter 260 that is distal to the actuator 270 from aportion of the catheter 260 that is proximal to the actuator 270. Thus,the portion of the catheter 260 that is proximal to the actuator 270 canextend through the opening 217 and at least partially outside of theintroducer 210 without contaminating the portion of the catheter 260distal to the actuator 270.

Any of the aspects and/or features of the embodiments shown anddescribed herein can be modified to affect the performance of thetransfer device. For example, the ribs in the set of ribs 236 of theintroducer 210 and the tab 273 of the actuator 270 can have any suitableshape, size, configuration, and/or arrangement to produce a desired setof characteristics associated with the movement of the actuator 270relative to the introducer 210, as described above. By way of anotherexample, any of the components of the transfer devices 100 and/or 200can be formed from any suitable material that can result in a desiredhardness, durometer, and/or stiffness of that component. For example, insome embodiments, at least the proboscis 242 of the lock 240 can beformed from a substantially rigid material such as a metal or hardplastic. In such embodiments, forming at least the proboscis 242 fromthe substantially rigid material can increase the structure supportprovided by the proboscis 242 to a PIV when the proboscis 242 is atleast partially disposed therein. Similarly, the proboscis 242 canprovide support to and/or otherwise can guide the catheter 260 when thecatheter 260 is moved therethrough.

Where methods and/or schematics described above indicate certain eventsand/or flow patterns occurring in certain order, the ordering of certainevents and/or flow patterns may be modified. Additionally certain eventsmay be performed concurrently in parallel processes when possible, aswell as performed sequentially.

What is claimed is:
 1. An apparatus, comprising: a catheter having aproximal end portion and a distal end portion and defining a lumenextending through the proximal end portion and the distal end portion;an introducer configured to receive the catheter, the introducer havingan outer surface forming a plurality of ribs, and defining an innervolume and a slot in communication with the inner volume, the innervolume configured to receive the catheter, a distal end portion of theintroducer configured to be coupled to an indwelling peripheralintravenous line; and an actuator having a first portion and a secondportion, the actuator operatively coupled to the introducer, the firstportion of the actuator disposed outside of the inner volume, the firstportion including a surface in contact with the outer surface of theintroducer, the second portion of the actuator extending through theslot and disposed within the inner volume, the second portion of theactuator being coupled to the catheter and extending through the slotdefined by the introducer such that the first portion of the actuator isin contact with at least one rib from the plurality of ribs, theactuator configured to be moved relative to the introducer to move thecatheter between a first position in which the catheter is disposed inthe introducer and a second position in which the distal end portion ofthe catheter is disposed beyond at least a portion of the indwellingperipheral intravenous line when the introducer is coupled to theindwelling peripheral intravenous line, the first portion of theactuator configured to move along at least a portion of the ribs fromthe plurality of ribs as the actuator moves the catheter between thefirst position and the second position, the surface of the actuator andthe plurality of ribs providing a haptic output associated with aposition of the catheter.
 2. The apparatus of claim 1, wherein thehaptic output produced in response to the portion of the actuator beingmoved along at least the portion of the ribs from the plurality of ribsis a vibration of the actuator.
 3. The apparatus of claim 1, wherein themovement of the portion of the actuator along the plurality of ribsgenerates a vibration along at least a portion of the catheterconfigured to facilitate advancement of the catheter past an obstructionas the catheter is moved toward the second position.
 4. The apparatus ofclaim 3, wherein the obstruction is associated with at least one of ahub of the indwelling peripheral intravenous line, a shape of at leastone inner surface of the indwelling peripheral intravenous line, ordebris within a portion of the indwelling peripheral intravenous line.5. The apparatus of claim 1, further comprising: an adapter disposedbetween the distal end portion of the introducer and the indwellingperipheral intravenous line, the adapter having an inner surfacedefining a lumen, the lumen is configured to receive a portion of thecatheter as the catheter is moved between the first position and thesecond position.
 6. The apparatus of claim 5, wherein the movement ofthe portion of the actuator along the plurality of ribs generates avibration along at least a portion of the catheter configured tofacilitate advancement of the catheter past an obstruction as thecatheter is moved toward the second position, and the obstruction isassociated with at least one of a shape of at least one inner surface ofthe adapter, a hub of the indwelling peripheral intravenous line, ashape of at least one inner surface of the indwelling peripheralintravenous line, or debris within a portion of the indwellingperipheral intravenous line.
 7. The apparatus of claim 1, wherein eachrib from the plurality of ribs has an asymmetric shape, the portion ofthe actuator is configured to move in the distal direction along atleast the portion of the ribs from the plurality of ribs with a firstset of characteristics, the portion of the actuator is configured tomove in the proximal direction along at least the portion of the ribsfrom the plurality of ribs with a second set of characteristicsdifferent from the first set of characteristics.
 8. The apparatus ofclaim 1, wherein the plurality of ribs includes a first plurality ofribs and a second plurality of ribs, each rib from the first pluralityof ribs has a first size, each rib from the second plurality of ribs hasa second size different from the first size.
 9. The apparatus of claim8, wherein each rib from the first plurality of ribs is adjacent to atleast one other rib from the first plurality of ribs and each rib fromthe second plurality of ribs is adjacent to at least one other rib fromthe second plurality of ribs, the first plurality of ribs being disposedalong the introducer proximal to the second plurality of ribs.
 10. Theapparatus of claim 8, wherein each rib from the first plurality of ribsis larger than each rib from the second plurality of ribs.
 11. Theapparatus of claim 8, wherein the portion of the actuator is configuredmove along at least a portion of the first plurality of ribs and atleast a portion of the second plurality of ribs as the actuator movesthe catheter between the first position and the second position.
 12. Theapparatus of claim 11, wherein the portion of the actuator and a ribfrom the first plurality of ribs collectively produce a first hapticoutput as the portion of the actuator is moved relative to that rib fromthe first plurality of ribs, the portion of the actuator and a rib fromthe second plurality of ribs collectively produce a second haptic outputas the portion of the actuator is moved relative to that rib from thesecond plurality of ribs, the second haptic output is different from thefirst haptic output.
 13. The apparatus of claim 1, wherein theintroducer has an inner surface defining the inner volume of theintroducer, the inner surface having a tortuous cross-sectional shapesuch that a portion of the inner surface is disposed in a line of sightbetween the slot and the catheter disposed within the inner volume. 14.The apparatus of claim 1, further comprising: a lock coupled to thedistal end portion of the introducer, the lock configured to contact aportion of the indwelling peripheral intravenous line to couple thedistal end portion of the introducer to the indwelling peripheralintravenous line, the lock defines a lumen configured to receive aportion of the catheter as the catheter is moved between the firstposition and the second position.
 15. The apparatus of claim 14, whereinthe lock includes a proboscis having an outer surface configured to beplaced in contact with an inner surface the indwelling peripheralintravenous line when the lock is coupled to the indwelling peripheralintravenous line.
 16. An apparatus, comprising: a catheter having acatheter proximal end portion and a catheter distal end portion; anintroducer configured to receive the catheter, the introducer comprisingan introducer proximal end portion, an introducer distal end portion,and an outer surface having a plurality of ribs extending at leastpartially between the introducer proximal end portion and the introducerdistal end portion, wherein the plurality of ribs comprises a first ribportion having ribs with a first set of characteristics and a second ribportion having ribs with a second set of characteristics different fromthe first set of characteristics, a position of the first rib portionbeing proximal to the second rib portion, the introducer distal endportion configured to be coupled to an indwelling peripheral intravenousline; and an actuator coupled to the catheter and extending through aslot defined by the introducer such that a portion of the actuator is incontact with at least one rib from the plurality of ribs, the actuatorconfigured to be moved relative to the introducer to move the catheterbetween a first position in which the catheter is disposed in theintroducer and a second position in which the catheter distal endportion is disposed beyond at least a portion of the indwellingperipheral intravenous line when the introducer is coupled to theindwelling peripheral intravenous line, the portion of the actuatorconfigured to move along at least a portion of the ribs from theplurality of ribs as the actuator moves the catheter between the firstposition and the second position to provide to a user a haptic outputassociated with a position of the catheter.
 17. The apparatus of claim16, wherein the haptic output produced in response to the portion of theactuator being moved along at least the portion of the ribs from theplurality of ribs is a vibration of the actuator.
 18. The apparatus ofclaim 16, wherein the movement of the portion of the actuator along theplurality of ribs generates a vibration along at least a portion of thecatheter configured to facilitate advancement of the catheter past anobstruction as the catheter is moved toward the second position.
 19. Theapparatus of claim 16, wherein each rib from the plurality of ribs hasan asymmetric shape, the portion of the actuator is configured to movein the distal direction along at least the portion of the ribs from theplurality of ribs with the first set of characteristics, the portion ofthe actuator is configured to move in the proximal direction along atleast the portion of the ribs from the plurality of ribs with the secondset of characteristics different from the first set of characteristics.20. The apparatus of claim 16, wherein the first rib portion includes afirst plurality of ribs and the second rib portion includes a secondplurality of ribs, each rib from the first plurality of ribs has a firstsize, each rib from the second plurality of ribs has a second sizedifferent from the first size.